The first thing to realize about toothpaste is that it is a medicine. It is so commonly bought and used that it is difficult to realize this. However all toothpastes are designed to clean your teeth to prevent the 2 commonest diseases in the country (gum disease and dental decay). It is therefore a medicine.


As with many medicines such as painkillers and antihistamines, there are a vast variety of toothpastes you can buy – and a few that are only available on prescription. Hopefully this article will help you when you next come face to face with the toothpastes in your local chemist’s or supermarket.


So What is in Toothpaste?

Things have come on a long way since tree bark, salt, baking soda or soot from the fireplace were used with the finger, old rag or cloth to clean teeth. The stuff you squeeze out of a tube is highly researched and developed.

Basically  toothpaste contains detergent and fine gritty particles which remove food debris and disrupt the film of plaque which constantly builds up on your teeth before it gets a chance to cause damage to your teeth and gums. Added to this is a foaming agent, colouring and flavourings to make it more acceptable and marketable

Since 1914 fluoride has been added to toothpastes to help in the fight against decay. This has been almost commonplace in toothpastes since about 1970, although there are still some unfluoridated toothpastes available.

The main differences in various modern fluoride toothpastes lie in four areas:

  • Anti-sensitivity
  • Whitening
  • Plaque/tartar control
  • Resurfacing


Anti Sensitivity

The likes of Sensodyne (with potassium nitrate) and Colgate Sensitive Pro-Relief (Arginine) have added ingredients which are designed to block minute pores in parts of your teeth which can be exposed at gum level and prevent the momentary pain hot and cold things can cause. As well as toothpaste, they can be effective by merely placing on the affected part of your tooth last thing at night, like an ointment, without rinsing it off.



A number of toothpastes claim to “whiten” teeth. The only way to do this is to have your teeth professionally whitened using tooth-bleaching agents and techniques. However these toothpastes do contain chemical agents which will dissolve stains which have become engrained onto the surface of your teeth. In general the more expensive the “whitening” toothpaste, the more chemicals it has to dissolve more stains. The older “smokers” toothpastes and powders are very abrasive and damage teeth. These appeared to whiten teeth by scratching away at the enamel surface and should be avoided.


Plaque/Tartar Control

Chemicals called “pyrophosphates” (e.g. sodium pyrophosphate) are added to some toothpastes as they have some benefit in preventing plaque build-up on teeth and therefore can play a, limited, part in helping to prevent gum disease and decay. In toothpaste and dental floss, sodium pyrophosphate acts as a tartar control agent, serving to remove calcium and magnesium from saliva and thus preventing them from being deposited on teeth.

The addition of triclosan to toothpaste is designed to inhibit bacterial metabolism within plaque. Its effect has been shown to last for approximately 8 hours after brushing. However, and despite animal studies which have shown it to have a negative effect on muscle strength, American and European agencies declaring triclosan safe at the levels manufacturers place in their products.

Despite these chemicals, the most important factor, by far, in plaque control is proper brushing and cleaning between the teeth.



In recent years there have been many toothpastes which claim to “resurface” teeth. The science behind this is that the added microscopic particles calcium, phosphate and carbonate in the toothpaste penetrated minor flaws in the tooth surface, where they bond with the natural structure of the tooth enamel. This, it is claimed, makes the tooth surface smoother and less likely to decay or allow plaque to stick. The other benefit is that such “repairing” minerals will bond to the tooth and help to reduce sensitivity. Fluoride helps in this remineralising process.

Again the benefits of such toothpaste are small in comparison to the importance of proper cleaning. These toothpastes include “Pronamel” and “Repair and Protect”.



Sodium Lauryl Sulphate

This is added to many personal care products, including many toothpastes, as a detergent. There is some controversy over its possible toxic effects, but it is reckoned to be safe at the levels it is found in toothpastes and shampoos, etc. (Otherwise it would not be used.) You can read all the debate about it – as with most things – on the internet.

If you are concerned about sodium lauryl sulphate, there are alternative toothpastes. (E.g. Biotene, sensodyne, and Tom's


Natural/Herbal Toothpastes

There are a large number of herbal toothpastes which are becoming increasingly popular for a variety of reasons. For example some people are concerned or even sensitive to some ingredients in regular toothpastes. They also appeal to those who are concerned about the environment. Many of these have flavourings other than the mint some people do not like in most available toothpastes.

Some of these natural toothpastes are even fluoride-free. However no dentist would recommend using a fluoride-free toothpaste. I shall write a piece on fluoride soon, which will show the 5 beneficial ways in which fluoride helps to prevent dental decay. For example there is a range of toothpastes made by Kingfisher and Tom’s of Maine Anticavity Toothpaste Children Strawberry. 

As I wrote at the top of this article, toothpaste is a medicine. In the last 2 years dentists have been able to prescribe toothpaste with higher concentrations of fluoride, than can be bought over the counter, to their patients whom they assess as having higher than average risk of decay.

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